Using the stages of change model to develop an understanding of caregiver intent for family behavior change following pediatric testing for genetic obesity: A qualitative analysis.

Introduction: Obesity rates continue to rise in children and adolescents worldwide. The heritability of obesity is estimated to be 40-80 %. Genetic testing for monogenic causes of obesity in the clinical setting is increasing; however, how results of these tests affect family behaviors is unclear. The objective of this study was to understand caregiver intent to change family behaviors following genetic testing for obesity. Methods: The sample from this qualitative analysis derives from a larger study identifying mutations on the melanocortin 4 receptor (MC4R) pathway. Inclusion criteria included participation in the main study, aged 2-17 years, and a history of severe obesity and hyperphagia. Caregiver-child dyads were recruited to ensure equal representation of genetic results across racial/ethnic subgroups (Non-Hispanic White, Black, Hispanic). A third of participants in the main study enrolled in the sub-study. Structured caregiver interviews were analyzed using grounded theory. Results: Twenty caregivers were female, 55 % White, 45 % Black, and 5 % Hispanic. Mean caregiver age was 42.3 ± 6.5 years and BMI 40.5 ± 7.9 kg/m Conclusions: Genetic testing for pediatric obesity, regardless of test outcome, motivates caregivers to move forward within the SoC Model or to remain in their current stage. These findings suggest that engaging caregivers to have their child with obesity tested for a genetic cause of obesity does not cause families to stop engaging in behavior change, unless the family was not ready to engage in behavior change prior to genetic testing.